Cleft Rhinoplasty- Columellar lengthening prolabial reconstruction with Abbe flap

Abstract

Introduction:A single center's experience of correction of cleft lip/palate associated rhinoplasty using Abbe flap is relatively rare in literature. The outcome and perception of the Abbe flap for cleft rhinoplasty at patient, surgeons, and patient's caregiver level have not been found in literature. This manuscript aims to address this lacuna through the use of rhinoplasty outcomes evaluation questionnaire (ROEQ).Materials and Methods:A retrospective analysis of preoperative satisfaction and prospective analysis of postoperative satisfaction of patients who underwent cleft rhinoplasty were carried out using ROEQ. This was used twice measuring the pre- and post-operative periods.Results:Twenty-one cases of bilateral cleft lip and palate who had earlier undergone (0.5–3 years back) cleft rhinoplasty and lip revision with Abbe's flap formed the study group. The mean age of the 21 subjects was 22.87 ± 4.23 years. There were 13 males and 8 females forming the study group. The mean presurgical ROEQ score was 19.8 ± 11.2, while the postsurgical score was 78.5 ± 21.2. This difference was statistically significant (P = 0.001). The difference in score between the time period was 58.7%.Discussion:From the ROEQ and other qualitative parameters, it is possible to demonstrate the impact of Abbe flap for cleft rhinoplasty and its impact on the quality of life of patients. Most of the patients and caregivers believed that this approach achieved a good or excellent postoperative result. The biological and operators factors behind such a success are discussed in light of previously published literature.

The Psychosocial Patient-Reported Outcomes of End of Pathway Cleft Surgery: A Systematic Review

“…Sawyer et al (2017) found the postsurgery scores were comparable between the cleft and non-cleft rhinoplasty groups, which the authors suggest is promising given cleft rhinoplasty represents a greater surgical challenge. The other studies report similarly high postsurgical satisfaction with nasal appearance, though 2 were retrospective and asked patients to complete both the pre- and post-ROE after surgery (Hens et al, 2011; Balaji, 2016), which may have biased results in favor of surgery. Balaji (2016) also provided patients with presurgical profile photographs to aid their memory in completing the presurgery measure, which may have unintentionally further biased results.…”

“…The study also does not make clear when the satisfaction measure was administered which could have affected ratings. One retrospective study used a 3-point rating scale of post-rhinoplasty success (unnoticeable, obvious, deformed) and found most patients perceived their postsurgery visible difference as unnoticeable, with 9 of 21 perceiving their scar as obvious to themselves but not others (Balaji, 2016).…”